Elder Abuse Vs. Nursing Home Abuse

elder abuse vs. nursing home abuseApproximately 60,000 Ohioans, age 65 and older, have been mistreated, injured or exploited by someone they relied upon for care or protection, according to an Ohio Attorney General report on elder abuse in both domestic and institutional settings. The U.S. Department of Justice reports at least one in nine seniors, 60 and older, are abused each year. The National Research Council estimates between one and two million persons nationally over the age of 65 have suffered some type of neglect, abandonment, financial exploitation or physical, sexual, verbal or emotional abuse. Research on the mortality of elder abuse victims indicates they are three times more likely to die within three years of the incident of abuse than non-victims.

Are elder abuse and nursing home abuse the same thing?

No. A nursing home abuse case is a civil action taken against the nursing home and the staff of a managed care facility. A lawsuit arises when a resident of a facility is injured as a result of the negligence of the institution. These suits often result in a change of behavior at the nursing home facility and a monetary award to the injured party or their estate.

Although there is no universally accepted definition of “elder abuse,” it represents any act that causes harm or creates a risk of harm to a vulnerable older person by someone in a relationship of trust to that older person. It is also the failure of a caregiver to provide for the basic needs of an older person or to protect the older person from harm. Elder abuse is a crime. The older individual is generally abused by a private party — a relative or caregiver. Many professionals are required to report suspected abuse.

However, despite mandatory reporting laws, elder abuse is largely hidden and is typically not reported to authorities. An estimated one in 14 instances of elder abuse is reported. Recent statistics supplied by proseniors.org reveals the average elderly abuse victim is a female aged 75 or older who is more than likely dependent on others for food, medication and personal care.

Abuse is sometimes preceded by a sudden decline in the older person’s health. Women are more than twice as likely to be abused as men—67% compared to 32%. Perpetrators are adult children (33%), other family members (22%), strangers (16%) and spouses or intimate partners (11%). More than half of perpetrators are women. A single incident of abuse is likely to trigger a downward spiral leading to loss of independence, serious illness or even death.

The Ohio Revised Code (ORC) defines “abuse” as infliction upon an adult by self or others of injury, unreasonable confinement, intimidation or cruel punishment with resulting physical harm, pain or anguish. “Neglect” is the failure of an adult to provide the goods or services necessary to avoid physical harm, mental anguish, or mental illness or the failure of a caretaker to provide such goods or services. “Exploitation” is the unlawful or improper act of a caretaker using an adult or an adult’s resources for the caretaker’s monetary or personal benefit, profit or gain.

What are some signs that abuse or exploitation is occurring?

  • Bodily injuries such as fractures, lacerations, abrasions or burns may suggest physical abuse
  • Sexually transmitted diseases, pain, itching, bleeding or bruising in the genital area
  • An anxious or withdrawn elderly person who has low self-esteem or may be depressed or confused
  • Theft of money or property would indicate financial abuse or exploitation of the elderly
  • Malnutrition, poor personal hygiene, over-and-under medication of the elderly individual and deprivation of stimulation or affection are other forms of neglect and abuse

Causes of elder abuse

With smaller families, increased mobility and strained economic times, there are limited family resources to deal with the care of the elderly. Responsibility falls to the few and the abuser may have an inability to cope with stress due to:

  • Divorce or unemployment
  • Financial problems, often including the cost of caring for the older person
  • Unresolved family conflicts involving the elderly relative
  • Declining health of the elderly person
  • Age-related diseases that physically or mentally impair the elderly person and medications that can alter an older person’s behavior
  • Demands on the personal time of the caregiver

Other contributing risk factors include caregivers’ misuse of alcohol and/or drugs; previous violence—the caretaker being an abuser or victim of abuse in the past and isolation of the abuse victim.

Why elder abuse goes unreported

  • The victim is afraid to report the abuse because he has been threatened and fears the abuse may get worse if he tells someone about it
  • The victim fears they will not be believed or that someone will think they are delusional
  • It may be hard to reach out to family members if lines of communication have been damaged over the years – often there aren’t any friends or family to tell about abusive treatment
  • The victim lacks the capacity to identify, report and prosecute abusers

What can be done to prevent abuse of the elderly?

The older person can take steps to protect themselves from financial abuse by becoming familiar with their finances, especially if they did not typically handle the finances. Have retirement checks deposited directly into your bank account and plan for incapacity by granting durable power of attorney to a trusted person who can monitor and handle your finances when you are no longer able to do so.

Do not sign any agreement that you do not completely understand.

Try to maintain a network of friends and community relationships and not totally rely on family members for emotional support. If you are a caregiver, make an effort to spend some time away from your elderly loved one so you are not overwhelmed with your responsibilities.

Agencies that can help

Agencies which have roles in elder abuse prevention are federal, state and locally mandated. The federal Older Americans Act governs the Ohio Department of Aging and its area Agencies on Aging. State agencies include the Ohio Department of Job and Family Services and its county Adult Protective Services (APS) programs, the Ohio Attorney General’s Office and the Ohio Departments of Insurance, Health, Mental Health and Mental Retardation/Developmental Disabilities (MRDD).

Local agencies demonstrating their interest through prevention, advocacy or educational activities are the Ohio Coalition for Adult Protective Services, Ohio Domestic Violence Network, Action Ohio, Ohio Association for Area Agencies on Aging, and the Ohio Association of Regional Long-Term Care Ombudsmen.

Little effort has been made over the years to mobilize these diverse agencies and channel their resources toward fighting elder abuse. In 2014, Ohio Attorney General Mike DeWine announced the Elder Justice Initiative aimed at combining the efforts of the state’s Crime Victim Services unit with the work of local officials to identify, investigate and prosecute elder abuse cases. The Initiative also aims to increase advocacy for the abused elderly and to promote public awareness of the issue. Crime Victim Services is collaborating with the Bureau of Criminal Investigation, Consumer Protection, Health Care Fraud and special prosecutors.

How to report elder abuse?

All reports of suspected abuse, neglect and exploitation must be made to the County Department of Job and Family Services (CDJFS). You can find the correct telephone number for Adult Protective Services (APS) in your county by going to the Ohio Department of Job and Family Services (ODJFS) website or by calling 614-466-6282.

If you file an abuse report in good faith, you are immune from civil or criminal liability. Your employer cannot retaliate against you. The report should include the name, address and approximate age of the abused adult, the name and address of that adult’s caregiver, the nature and extent of the suspected abuse, neglect, or exploitation, and what makes you believe abuse has occurred.

The following categories of professionals are required to report suspected abuse: attorneys, physicians, chiropractors, dentists, psychologists, any employee of a hospital, any nurse, any employee of an ambulatory health facility, any employee of a home health agency, an adult care facility, a community alternative home, a nursing home, a residential care facility, or home for the aging, any senior service provider, any peace officer, coroner, clergyman or any employee of a community mental health facility and any person engaged in social work or counseling.

“Emergency” reports must be investigated within 24 hours and all other reports within three working days. An emergency report is one in which there is substantial risk of immediate physical harm to an individual or others. The APS investigator must meet with the abused adult and when possible, consult with the person who made the report. Written notice of the intent of the investigation must be given to the allegedly abused adult. A written report must also be issued confirming or denying the need for protective services.

The court must issue a protective order if it finds:

  • The adult has been abused, neglected or exploited
  • The adult is in need of protective services
  • The adult is incapacitated
  • No other person authorized by law is available to give consent

The order can last not more than 6 months, but can be re-authorized for up to a year.

Ohio laws affecting elder abuse

ORC 5101.60 to 5101.72 outlines the Adult Protective Services Law. ORC 2903.34 defines patient abuse and neglect in institutional care facilities.

ORC 109.86 covers investigation of abuse or neglect of a care facility patient and prosecution of these matters. ORC 173.14 defines the Office of the State Long-term Care Ombudsman Program, explains the the appointment of the state ombudsman and outlines conflicts of interest.

Chapter 3701-64 of the Ohio Administrative Code establishes rules for the Department of Health to receive, review and investigate allegations of abuse or neglect of a resident or misappropriation of the property of a resident by any individual used by a long-term care facility or a residential care facility to provide services to residents.

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